How GP Work Pressures are Hindering Cancer Prevention Efforts

Intensifying work pressures in GP surgeries are preventing the effective delivery of cancer prevention information, according to a new report from healthcare researchers at the University of Ulster. The findings were revealed today at an All Party Cancer Group meeting at Stormont facilitated by Cancer Focus. You can download the report or summary report here.  

Every year in Northern Ireland 11,200 people are diagnosed with cancer1 yet many of these cases could be prevented. Although GPs and nurses in GP surgeries are the best placed health professionals to deliver cancer prevention information in primary care, they lack time and resources to do so effectively, the report says.

The report, compiled by a research team at the University of Ulster and funded by Cancer Focus Northern Ireland, also concluded that consideration should be given to providing Primary Care Nurses with a more formal cancer prevention role.

The aim of the study was to investigate the current and potential role of the GP and the primary care nurse in the prevention of cancer through health promotion strategies.

The report showed that smoking cessation and cancer screening were the most common cancer prevention activities carried out in GP clinics. The report also found that, due to time constraints during consultations, opportunities to discuss cancer prevention issues with patients are not always maximised.

It revealed that the link between cancer and the key risk factors of alcohol consumption, obesity, diet and physical activity were generally only discussed with patients when they presented themselves to GP surgeries with a related health problem. Primary Care Nurses often have a relationship with patients different to the GP patient relationship, with some patients perceived to be more comfortable in conversations with nurses. This may make them better placed to provide cancer prevention advice, and over a period of time allow more opportunities to discuss beneficial lifestyle choices. 

Lead researcher Professor Hugh McKenna, from the University of Ulster, said: “GPs and practice nurses are extremely busy people. This means that once they deal with the patient’s presenting symptoms they have limited time to undertake health promotion activities relating to cancer prevention.

This is unfortunate because they are held in very high regard by communities and there is the probability that their advice on lifestyle issues such as diet, alcohol, exercise, and smoking would be heeded by patients and families.”

Roisin Foster, Chief Executive, Cancer Focus, said a number of recommendations have been made to improve cancer prevention awareness.

“The report has found that practice nurses may be best placed to further develop the cancer prevention role in local GP clinics. This is possibly due to both their training and the fact that they may not be so restricted by appointment pressures.

Cancer Focus provides training in cancer prevention2 and early detection for local health care professionals.  We actively seek ways in which we can encourage more training to help in the fight against cancer. 

Health promotion programmes need to be developed in a co-ordinated way involving both doctor and nurse practitioners as both agree that their current level of knowledge could be improved on.

It is interesting and important that GPs and nurses both agreed that Primary Care Nurses were better placed to provide cancer prevention activities and acknowledge that cancer prevention is an integral part of their roles but that both also identified time constraints as a real issue in delivering this.”

The University of Ulster research team included Dr Sinead Keeney, Dr Sonja McIlfatrick and Dr Nigel McCarley. The researchers surveyed 345 general practice surgeries and carried out a number of one-to-one interviews with GPs and Primary care nurses within Northern Ireland.